The pathogenesis of chronic hepatitis B (CHB) involves complex mechanisms, and hepatitis B virus (HBV)-induced immune responses play a central role in hepatocyte injury and inflammatory necrosis. CHB infection not only drives liver pathology but also demonstrates significant extrahepatic associations which include depression, cognitive dysfunction, diabetes mellitus, insomnia, non-alcoholic fatty liver disease, and thrombocytopenia. Conventional Western medicine primarily employs antiviral therapy but faces limitations which include low hepatitis B surface antigen clearance rates and frequent adverse drug reactions. In contrast, traditional Chinese medicine demonstrates therapeutic advantages in CHB management which are exemplified by Artemisia capillaris, Xiaochaihu Decoction and Fuzheng Huayu Tablet. Through its modulation of immune pathways and intervention in key HBV lifecycle targets, traditional Chinese medicine achieves a tripartite therapeutic synergy that combines immune reconstitution, viral suppression, and hepatic repair. Chinese medical interventions exhibit characteristic multi-ingredient, multi-target mechanisms that possess immunomodulatory effects in CHB management. Future research should employ modern technologies to elucidate these mechanisms further and thus facilitate the development of optimized treatment protocols. Standardized therapeutic approaches derived from such evidence will hold significant clinical value.

The interaction of helminth infections with type 2 diabetes (T2D) has been a major area of research in the past few years. This paper, therefore, focuses on the systematic review of the effects of helminthic infections on metabolism and immune regulation related to T2D, with mechanisms through which both direct and indirect effects are mediated. Specifically, the possible therapeutic role of helminths in T2D management, probably mediated through the modulation of host metabolic pathways and immune responses, is of special interest. This paper discusses the current possibilities for translating helminth therapy from basic laboratory research to clinical application, as well as existing and future challenges. Although preliminary studies suggest the potential for helminth therapy for T2D patients, their safety and efficacy still need to be confirmed by larger-scale clinical studies.

Perlman syndrome is a rare autosomal recessive overgrowth disorder with a predisposition to Wilms tumor, caused by biallelic variants in DIS3L2. The majority of patients die in infancy due to respiratory and/or renal failure, limiting the reports of patients surviving into childhood.

Exome sequencing was performed in the proband and her older brother. A younger sibling subsequently underwent targeted variant analysis. RNA sequencing was utilized to investigate the functional impact of the missense variant.

Three siblings presented at birth with fetal macrosomia, dysmorphic facial features, and facial hypotonia. The proband had early speech delay and was diagnosed with Wilms tumor at 3 years old. Her brothers both had developmental delay presenting within the first year of life. Genetic testing identified compound heterozygous variants in DIS3L2 (NM_152383.5): c.127C>T (p.Arg43Ter) (paternal)/c.2381G>A (p.Arg794His) (maternal).

Our findings expand the genetic and clinical spectrums associated with Perlman syndrome and increase the understanding of the phenotype observed in childhood. They also support consideration of genetic testing for Perlman syndrome in individuals and sibships with macrosomia, developmental delay, and characteristic facial dysmorphisms, with or without the presence of Wilms tumor.

A relationship between long-term metformin use and vitamin B12 deficiency has been long discussed in the literature. Nonetheless, prior to 2022, there was no official guidance. In June 2022, the Medicines and Healthcare products Regulatory Agency (MHRA) published advice, stating that low vitamin B12 is now considered to be a common side effect. It advises checking levels in patients with symptoms of B12 deficiency, as well as monitoring those at risk of B12 deficiency.Despite efforts to promote evidence-based practice, there is still a gap in the translation of research findings into policies and clinical practice. The above research has been shared widely in the academic and specialist diabetes literature over a prolonged period. The purpose of the scoping review is to explore what evidence is available regarding clinicians' awareness of the association between metformin use and vitamin B12 deficiency in patients with type 2 diabetes mellitus, how this evidence is implemented into frontline clinical practice and what screening processes are recommended or exist.

This is a protocol for a scoping review to be guided by the Joanna Briggs Institute (JBI) methodology for scoping reviews 20. The databases to be searched will include MEDLINE (accessed via PubMed), British Nursing Index, Google Scholar, Cochrane, Embase, Web of Science and Cumulative Index to Nursing and Allied Health Literature (CINAHL) (accessed via EBSCO), alongside searching for grey literature such as Electronic Theses Online Service (EThOS), DART European and Kings College London Research Portal. Titles and abstracts of articles will be reviewed by the authors. If articles are representative of the inclusion criteria, the articles will go through a full-text review by the authors. The results of the search and study inclusion/exclusion process will be reported and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram. Data will be extracted from papers, using the recommended JBI data extraction tool. The search will commence in August 2025, and the review is expected to be completed by November 2025.The search will commence in August 2025, and the review is expected to be completed by November 2025.

As this is a scoping review protocol that did not involve any human participants, human data or human tissue, no ethical approval was required. Our dissemination strategy includes peer review publication, presentation at conferences and with relevant stakeholders.

Our objective was to assess retinal microcirculation and photoreceptor parameters in both healthy individuals and patients with vascular retinal diseases using adaptive optics ophthalmoscopy. This technology enhances optical system resolution to 2 µm by correcting wavefront aberrations, revolutionizing in vivo studies of ocular structures.

Our study examined the clinical applications of adaptive optics in both healthy individuals and patients with vascular retinal diseases, including nonproliferative diabetic retinopathy, proliferative diabetic retinopathy, and macular telangiectasia (MacTel) type 2.

In our study, we observed a higher wall-to-lumen ratio (WLR) value in our patient with proliferative diabetic retinopathy compared to our healthy volunteer. Additionally, we found a positive correlation between WLR and the severity of diabetic retinopathy. Furthermore, cone density was lower in all quadrants of our patient with proliferative diabetic retinopathy. For our patient diagnosed with MacTel type 2, the cone mosaic appeared irregular and blurred, with notable cone loss, especially on the temporal side of the macula, consistent with the typical location of MacTel type 2 lesions.

Adaptive optics imaging assesses retinal changes in vascular diseases despite acquisition challenges. The obtained images aid in tracking the progression of diabetic retinopathy and detecting early changes of MacTel Type 2. Our study highlights both vascular and photoreceptor changes, quantifying these parameters to enhance the understanding of these vascular diseases.

Adaptive optics imaging is an advanced technique that provides high-resolution visualization of the microstructure of retinal vasculature and photoreceptors. This technology enhances our understanding of both healthy and vascular retinal conditions, aiding in diagnosis, monitoring, and prognosis.

For early-stage Diabetic retinopathy (DR), various pharmacological agents and neuroprotective factors have been developed. However, these treatments often show limited efficacy, especially when initiated after retinal damage, and may cause adverse effects. Therefore, there is an urgent need to develop safer and more effective therapeutic strategies for early-stage DR. Shenzhuo Formula (SZF), a modified classical traditional Chinese medicine prescription, has shown promising clinical efficacy in early-stage DR treatment. This study aims to investigate the underlying mechanisms of SZF to expand treatment strategies for DR.

SZF components were analyzed using Ultra Performance Liquid Chromatography-Quadrupole Time-of-Flight Mass Spectrometry/Mass Spectrometry (UPLC-Q-TOF-MS/MS). Db/db mice received three different SZF doses for 12 weeks. Physiological parameters, including water and food consumption, body weight, and urine output, were monitored. Blood samples were analyzed for fasting blood glucose and other relevant parameters. Ocular changes were assessed using fundus photography (FP), fundus fluorescein angiography (FFA), optical coherence tomography (OCT) and hematoxylin and eosin (H&E). Network pharmacology analysis (NP) identified potential SZF targets, while immunofluorescence staining evaluated SZF's mechanism in delaying DR progression. The distribution of SZF pharmacological targets in critical DR target cells was analyzed using single-cell data from the GSE245561 dataset. Molecular docking predicted SZF-target interactions.

SZF improved diabetic symptoms, increased retinal thickness, and reducedvascular leakage and microcirculation issues. The HIF-1α-VEGFA axis was suggested as a potential core target. Single-cell analysis of clinical samples suggested macrophages as a common target cell for HIF-1α and VEGFA. Molecular docking identified effective SZF components.

Results indicate that SZF may impede the progression of DR by inhibiting the HIF-1α-VEGFA signaling pathway in macrophages, with quercetin and apigenin identified as significant contributors, though further experimental validation is needed to confirm these mechanistic.

There is a dispute as to whether patients with psoriasis have impaired kidney function. We aimed to assess several recognized and experimental markers of glomerular filtration and tubular function in such patients to find out whether they have decreased kidney function.

The study involved 60 patients with psoriasis and 30 volunteers without dermatoses. The following molecules were analyzed by ELISA: serum creatinine, cystatin C, beta-trace protein, albumins, uromodulin; urinary albumins, cystatin C, alpha-1-microglobulin, beta-2-microglobulin, uromodulin, klotho, and fatty acid-binding protein 1, and nephrin.

The following absolute values of markers concentrations were measured in patients, respectively: serum-1.13 (0.6-1.9)mg/dl, 4.511 (2.356-10.31)mg/l, 19.8 (2.8-48)ng/mL, 4.2 (1.9-8.85)g/dl, 212.3 (32.35-583.9)ng/mL, urine-5 (3-39)g/dl, 24096 (79.94-99020)ng/mL, 0.9342 (0.2088-6.213)ng/mL, 22.65 (0.85-105.8)ng/mL, 6.388 (0.8960-15.94)ng/mL, 0.08 (0.002-0.387)ng/mL, 1.773 (1.706-2.146)ng/mL, 0.128 (0.095-0.298)ng/mL. The patients had significantly lower serum albumin concentration (p<0.001) and higher urinary albumin (p<0.05), significantly higher serum cystatin C (p<0.01), and absolute urinary nephrin (p<0.05). There was no difference between patients and controls in terms of serum creatinine or beta trace protein concentration (p>0.05). There were no significant differences in the concentration of the tubular markers (urinary cystatin C, alpha-1-microglobulin, beta-2-microglobulin, klotho, and fatty acid-binding protein 1) between patients and controls, except for serum and urinary uromodulin, which were significantly lower in patients (p<0.01, p<0.001, respectively). We found no significant correlations between the investigated markers' concentration and clinical or demographic parameters (p>0.05).

Despite the differences between patients and controls in terms of glomerular filtration markers, the median values of markers' concentration were within normal limits. Based on the assessment of the markers, it does not seem that impaired glomerular and tubular function occurs more frequently in patients with psoriasis. Nevertheless, due to the higher prevalence of diabetes mellitus and arterial hypertension in psoriatics and nephrotoxic properties of antipsoriatic drugs - caution must be exercised and easy screening tools should be considered.

The existing semi-quantitative ultrasound grading system inadequately evaluates synovial hypertrophy at the dorsal recess of the first metatarsophalangeal joint (MTPJ). Vitamin D deficiency is prevalent in type 2 diabetes mellitus (T2DM) and may influence joint inflammation. This study hypothesizes that serum 25-hydroxyvitamin D [25(OH)D] levels are inversely associated with synovial hypertrophy severity of the first MTPJ in patients with T2DM.

To refine ultrasound grading for the first MTPJ synovial hypertrophy and investigate its association with vitamin D in T2DM.

This cross-sectional study included 56 patients (112 MTPJs) with T2DM from Shenzhen Traditional Chinese Medicine Hospital. Synovial hypertrophy was evaluated using a refined semi-quantitative ultrasound grading system focusing on the dorsal recess overlying the metatarsal bone. Serum 25(OH)D levels were measured. Logistic regression and threshold analyses assessed associations between vitamin D status and hypertrophy severity.

Of 112 joints assessed, 98 exhibited synovial hypertrophy (grade 1: 40; grade 2: 50; grade 3: 8). The refined grading system demonstrated strong intra- and inter-observer reliability (intraclass correlation coefficients = 0.79 and 0.73, respectively). Lower serum 25(OH)D (< 24.3 ng/mL) was independently associated with moderate-to-severe hypertrophy [odds ratio (OR) = 0.83; P = 0.0163]. Vitamin D deficiency significantly increased the likelihood of moderate-to-severe hypertrophy compared with non-deficiency (OR = 3.86; P = 0.0422). Threshold analysis identified 23.8 ng/mL as a critical serum 25(OH)D level, below which each increment reduced moderate-to-severe hypertrophy risk by 21% (OR = 0.79; P = 0.0078).

The refined ultrasound grading system demonstrated strong reliability. Serum 25(OH)D may serve as a protective factor against the severity of synovial hypertrophy in T2DM patients with lower 25(OH)D levels.

This editorial delves into the potential of systemic immune indicators (SIIs) as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus. By exploring the recent study published by Cao et al, this article aims to highlight the importance of early detection and intervention. This study comprehensively analyzes various SIIs, examining their correlation with renal complications in newly diagnosed type 1 diabetic children. The findings reveal a significant association between immune system dysregulation and the onset of renal damage, suggesting that certain immune indicators can be early markers for predicting renal complications. This editorial emphasizes the clinical implications and applications of utilizing SIIs for early detection in pediatric diabetes care. It underscores the importance of innovative diagnostic approaches and illustrates real-world applications and outcomes. Additionally, it addresses the challenges and considerations in adopting these indicators and outlines future research directions to enhance diabetes management in children.

Increasing evidence has shown that hippocampal damage serves as a marker of early cognitive decline in patients with type 2 diabetes mellitus (T2DM); however, the association between hippocampal subregion volume changes and cognitive decline in different dimensions remains unclear.

To investigate changes in hippocampal subregion volumes in patients with T2DM and their relationship with cognitive function impairment.

Sixty patients with T2DM and 32 healthy controls were recruited. All participants underwent a 3.0 T magnetic resonance scan and a series of clinical assessments. Hippocampal subfield volumes were determined using FreeSurfer 7.4.1. A two-sample t-test was used to evaluate group differences. Partial correlation analysis was performed to assess the relationship between hippocampal subregion volumes and cognitive function. ^a P < 0.05 was considered statistically significant.

Compared with controls, the volume of right hippocampus-amygdala transition area (t = -3.053, P = 0.003) in patients with T2DM was significantly reduced, which was negatively correlated with the required time of the Trail Making Test (TMT)-A (r = -0.331, P = 0.028) and TMT-B (r = -0.402, P = 0.007) and positively correlated with the scores of Symbol Digit Modalities Test (r = 0.381, P = 0.011), Auditory Verbal Learning Test (AVLT)-N7 (r = 0.309, P = 0.041), and Digital Span Test (r = 0.300, P = 0.048). The volume of the right molecular layer (t = -2.998, P = 0.004) was also significantly reduced, which was positively associated with the scores of AVLT-N7 (r = 0.311, P = 0.045). In addition, the left hippocampal fissure volume (t = 3.617, P = 0.002) was significantly increased in patients with T2DM.

Declines in cognitive performance, especially memory and executive function, are linked to changes in the volumes of the right hippocampus-amygdala transition area and right molecular layer in patients with T2DM.